Inspection on 12/08/05 for Wingfield Road Care Home

This inspection was carried out on 12th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wingfield Road Care Home 12/09/06

Wingfield Road Care Home 06/01/06

Wingfield Road Care Home 18/11/04

Wingfield Road Care Home 21/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Sunflower Villa 22 Wingfield Road Trowbridge Wiltshire BA14 9ED Lead Inspector Tim Goadby Unannounced 12 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunflower Villa Address 22 Wingfield Road Trowbridge Wiltshire BA14 9ED 01225 762043 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Parkcare Homes (No 2) Limited Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 Brief Description of the Service: Sunflower Villa provides care and accommodation for up to 6 adults with a learning disability. The home is operated by a subsidiary of Craegmoor Healthcare, a private sector organisation with 4 registered care homes for this client group within Wiltshire. The service has been open for about 10 years, initially under different ownership. The home aims to provide long-term placements, and the current service user group is well established. The property is in a residential area of Trowbridge. A range of amenities are available in the town itself. Larger centres, such as Bath and Bristol, are within reasonable travelling distance. The home is a 3 storey semi-detached property. All service users have single bedrooms, 1 of which is on the ground floor. Communal facilities are also downstairs, along with the staff office and sleep-in room. Toilets are available on all 3 floors. The ground floor has a shower, and the 2 upper floors both have bathrooms. The home also has a pleasant enclosed garden at the rear. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in August 2005. A total of 5 hours was spent in the home. The following inspection methods have been used in the production of this report: indirect observation; sampling of records, with case tracking; sampling a meal; discussions with service users and staff; tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: 1 requirement from the last inspection, in November 2004, remained unmet. This was for guarding or repositioning of the cooker, for health and safety reasons. The intention was to address this within an overall refit of the Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 6 kitchen. But undertaking of this work has been substantially delayed. It must be addressed without further delay. Another premises issue in urgent need of attention was the offensive odour that was prominent in one room. The plan was to address this by provision of a new floor covering. Other areas of décor were also in need of refurbishment, and the quality of the environment overall would benefit from all these outstanding jobs being undertaken soon. Systems for response to any complaints received need to ensure that records are available in the home, to show all the steps that are being taken in response. When issues have been referred elsewhere within the organisation, the information kept in the home does not contain all relevant current details. When service users have episodes of disturbed behaviour, which have a bearing on their own welfare and that of others, these must be notified to the CSCI at the time that they occur. Systems for fire safety need attention to ensure that all relevant steps are being taken to minimise risks. This includes carrying out and recording all tests at the prescribed intervals, and documenting actions taken when any faults are identified. All staff also need to receive instruction at least once in every 3 months. The quality of service user records could be further enhanced by increasing the evidence of their own contribution to care planning, and reducing any duplication in risk assessments. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Standards relating to admissions to the home were not applicable at this inspection. The home is able to meet the needs of its service users. EVIDENCE: The home has not had any new admissions since 2000. The current service user group is well established. Information is available to describe their needs, and the strategies to support these. Staff support was seen to be in place for all service users throughout the day. Records also showed that a range of professionals and resources are accessed, to assist the home in meeting its service users’ needs. The majority of Sunflower Villa’s service users are independent in a number of areas, both at home and outside. Some need more input. These differences are clearly set out in the information about each individual, and support is tailored accordingly. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 9 Service users’ needs and goals are reflected in their individual care plans. Their own input to these could be developed further. Systems for risk management support the undertaking of social opportunities. EVIDENCE: A care plan format has been devised in-house. This addresses all required areas. Sampled records showed that each individual’s key strengths and needs are clearly set out. Reasons for the support given, including any restrictions imposed, are shown. Systems are built in for monthly review, with a more detailed review each 6 months. Some content of the care plans is written in the first person, and service users had signed to indicate their involvement in some reviews. But the input of residents could be shown more strongly. The home has begun working towards this, using an Outcome Based Evaluation format, which has involved service users in rating their own support needs. Risk assessments show consideration of positive reasons to take risks, as well as potential negative outcomes. Where possible, they place emphasis on the Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 10 support that can be given to enable an opportunity to be undertaken. It was seen that assessments and management strategies are reviewed in response to any significant changes. The level of support may be reduced or increased, depending on particular situations. The sampled records, whilst of good quality, contained some duplication. A number of risk assessments overlapped on the same topics, and could usefully be combined, to reduce the amount of paperwork that needs to be referred to. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 & 17 Service users have frequent opportunities to undertake a range of activities, both at home, and within their local community. Service users are supported to maintain personal and family relationships. Daily lives for service users have an appropriate balance between necessary routine, and individual choice. Arrangements for the provision of meals promote independence, choice and social inclusion. EVIDENCE: Issues of choice and autonomy are addressed in service user records. There is a focus on promoting independence. If restrictions are imposed as part of overall care, there are clearly documented reasons. Weekly programmes vary, depending on people’s needs and preferences. Facilities attended include the local college. One service user spoke about how Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 12 much they were looking forward to starting on an independent living course in September. Another talked about the various sessions they attend at a resource centre for adults with learning disability. Another local facility accessed by service users is a farm. When people are not attending other resources, activities are supported by staff of the home. A range of amenities are accessed in the local community. Many service users are able to do this independently. Risk management strategies are in place. Records showed that there has been success in enabling some individuals to become more independent, using a structured approach to develop their skills. The home has its own vehicle, which is used when needed. Over the summer period, regular outings were being offered. Service users could choose whether or not they wished to take part in these. Some people had also been away on holiday, supported by staff. All service users have regular family contact. This is maintained by phone calls and visits. Some individuals spend weekends with their relatives. At home, people choose whether to spend time in their own rooms, or in communal areas. Some environmental restrictions are in place. The staff office is locked when not in use. The first floor bathroom is also locked, for reasons which are clearly documented. And the pantry is used to ration access to food, and keep sharp knives out of reach. The kitchen remains open at all times. The main meal is served in the evening. Service users have a light lunch if they are at home during the day. It has recently been agreed that the cut-off point for breakfast is 10.30 a.m. So anyone getting up later than this has the option of a more substantial lunch instead. Menus are drawn up, based on the choices of service users. Alternatives are provided if necessary. People can also make drinks and snacks independently, if able to do so. Meals can be taken in the dining room, where staff and service users eat together. But people can also choose to eat in their own rooms, if they prefer. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Service users’ personal care and health needs are met. EVIDENCE: Many of the service users at Sunflower Villa are independent in aspects of personal care. Sampled records clearly set out the strengths and needs of each individual, and described any support that they might need. Records also clearly addressed health care needs. They provided evidence that all relevant professionals are involved. People had had access to medical advice, from both GPs and consultants. They were also up to date in other areas, such as dental care. Relevant indicators of health, such as weight, epileptic activity, or behaviour, are monitored within individual records. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Suitable procedures are in place to promote the welfare of service users. Complaints systems do not include a clear record in the home of all actions being taken in respect of ongoing issues. The home has failed to notify the Commission of all events adversely affecting the safety and well-being of service users. EVIDENCE: Craegmoor has appropriate procedures in place for complaints and protection. These are readily available in the home. Complaints information includes contact details for relevant senior people in the organisation, and for other agencies, such as the CSCI. There is also a pictorial version, intended to be more accessible for service users. Complaints records are kept in the home. But the information available to a recent complaint, which was still ongoing, did not include all up-to-date information. The issue had been referred to a higher level within Craegmoor, and this appeared to be why the in house record was not complete. The home supports some service users who may present with episodes of disturbed behaviour. These issues are clearly set out in individual records, with appropriate management strategies in place. Staff receive relevant training. Sampled records identified 3 recent incidents which had not been notified to the Commission, as required. These related to episodes of recorded aggression and non-compliance, both at home and outside. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 28 & 30 Service users live in a homely and comfortable environment. Some improvements to décor and fixtures would further enhance this. The home is clean and hygienic in the majority of areas. Offensive odours in one room present an unfavourable impression, and are detrimental to service users’ quality of life. EVIDENCE: Sunflower Villa is a semi-detached property in a residential area. It presents as no different to the surrounding houses. There is easy access to local amenities, and to public transport. The home is generally well maintained. Some areas of décor were in need of renewal. Staff reported that it can take lengthy periods for the necessary work to be approved. But it was anticipated that various jobs would be addressed soon after this inspection. In particular, the kitchen and the first floor bathroom were due for complete refurbishment. The ceiling in the ground floor lounge also needed attention, where it had been damaged by water from the bathroom above. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 16 Most areas of the home were seen to be clean and hygienic. There was a problem with a strong offensive odour in one room on the ground floor. This created an unpleasant environment for the individual concerned, and also presented a poor overall impression of the home for any visitors. Staff stated that the problem was due to be addressed by replacing carpet with a more easily cleanable floor surface. Suitable guidelines were in place regarding support for service users’ personal hygiene. These were linked to appropriate infection control procedures. Toilets and washing facilities are available on all 3 floors of the home. These include a shower on the ground floor. The first floor bathroom is kept locked when not in use, due to the known behaviours of a service user. Reasons for this are clearly documented. Communal areas are on the ground floor. The lounge is at the front of the house, and provides a natural focal point. Further back, the dining room leads through to the kitchen and utility room. The staff office and sleep-in room are at the rear. The home also benefits from a large area of enclosed garden, which is used during good weather. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Effective arrangements are in place to ensure suitable staffing cover to meet the needs and preferences of service users. EVIDENCE: The staff team at the time of this inspection consisted of a manager, deputy, 3 full-time and 2 part-time support workers, and also a relief support worker. There was 1 vacant full-time post, and 1 current staff member was due to leave shortly. Staff are provided at all times. There are a minimum of 2 staff on duty for all daytime shifts. This is often increased to 3, due to the presence of the manager or deputy. At night, 1 person sleeps in. There were 3 staff on duty throughout the period of this inspection, including a shift change in the afternoon. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Fire safety measures need attention, to ensure that the welfare of service users is promoted and protected. The layout of the kitchen presents risks to the safety of service users and staff. EVIDENCE: The home’s registered manager had left since the previous inspection. Ms Nichola Gardner has been appointed as the new manager, and is in the process of applying to the CSCI for registration. Since the previous inspection, steps have been taken to regulate hot water temperatures to the required safe level. Outlets checked during this visit were delivering it at the appropriate heat. Fire safety records were checked. The property’s fire risk assessment had been updated in December 2004, and covered all relevant topics. But there were deficits in various other aspects. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 19 Alarm system tests must be carried out each week. But these were only recorded for 3 of the previous 7 weeks, and the last documented test had been over 2 weeks before the day of the inspection. Tests of emergency lighting, and means of escape, must be carried out monthly. In both cases, the last recorded checks had taken place in June 2005. Also, faults had been identified for both, and there was no record to show whether or not these had been addressed. Staff reported that the necessary actions had been taken. Staff must receive instruction in fire safety at least once in every 3 months. But the home was only doing this once every 6 months. An unmet requirement from the previous inspection related to the siting of the cooker. This is in an area by a through route between the kitchen and utility room, which is in frequent use. This has been identified as a health and safety risk. The home plans to address the problem within an overall refit of the kitchen. But this remained outstanding. Staff expected that the necessary work was finally to be carried out shortly after this inspection. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x N/A 3 N/A x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 N/A 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sunflower Villa Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score N/A x x x x 2 x D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA22 Regulation 17(2) & (3), Schedule 4(11) 37(1)(e) Requirement A record must be kept of the actions taken by registered persons in respect of complaints; and such records must be at all times available for inspection in the care home. The persons registered must notify the Commission without delay of any event which adversely affects the well-being or safety of any service user. The persons registered must ensure that the home is kept free from offensive odours. Timescale for action From 12/08/05. 2. YA23 From 12/08/05. 3. YA30 16(2)(k) Not later than 30/09/05. 4. YA42 13(4)(a) COMMENT: The home plans to replace the floor covering in the affected room. The persons registered must Not later ensure that the cooker is than guarded, or relocated to a safer 30/09/05. position. (Timescale of 28/02/05 not met) COMMENT: The requirement is due to be addressed within a complete refit of the kitchen. This was expected to take place shortly after this inspection. Continued failure to address this requirement by the appropriate Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 22 5. YA42 timescale will lead to further enforcement action. 23(4), (c), There must be evidence that all (d) & (e) required checks and instruction relating to fire safety are carried out at the prescribed intervals. From 12/08/05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA6 YA9 YA24 Good Practice Recommendations The home should continue steps to promote greater input of service users into their own care plans. Risk assessments should be reviewed, to reduce any unnecessary duplication. Attention should be given to areas of decor in need of renewal. Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sunflower Villa D51_S28443_SUNFLOWERVILLA_v205986_100605Stage4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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